CHIEF COMPLAINT: Patient is a 60 year old Latin male presenting for evaluation of itchy patches in his bilateral axillae, inguinal region, and gluteal folds. Patient states this eruption is ongoing for the previous three months and is progressively worsening. He feels as if it began after starting a new medication.

CHIEF COMPLAINT: A 69 year-old, otherwise healthy woman was seen in our office for a painful, swollen left foot.

CLINICAL HISTORY:

Signs and symptoms: She reported a two-week history of worsening symptoms after stepping on a sharp object while walking barefoot at home. The patient experienced pain at the base of her left first toe, but could not identify an obvious puncture wound or foreign body at the time of injury.

CHIEF COMPLAINT: This is a case of a 39 year-old Caucasian female who presented with a skin rash of several months duration on the bilateral upper extremities and face. She later developed many extracutaneous manifestations including xerostomia, dysphagia, fatigue, anorexia with subsequent weight loss, and paresthesias of the bilateral lower extremities. Most disconcerting to her, however, was an accelerating loss of motor function; she had difficulty getting out of a chair and walking up stairs.

CHIEF COMPLAINT: 1.5 year history of a progressively worsening rash on the face, trunk, and upper and lower extremities, including the palms and soles. This was previously diagnosed as vitiligo and eczema.